DE69828176T2 - ISCHEMIA DETECTOR - Google Patents
ISCHEMIA DETECTOR Download PDFInfo
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- DE69828176T2 DE69828176T2 DE69828176T DE69828176T DE69828176T2 DE 69828176 T2 DE69828176 T2 DE 69828176T2 DE 69828176 T DE69828176 T DE 69828176T DE 69828176 T DE69828176 T DE 69828176T DE 69828176 T2 DE69828176 T2 DE 69828176T2
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- ischemia detector
- ischemia
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- 208000028867 ischemia Diseases 0.000 title claims description 57
- 238000001514 detection method Methods 0.000 claims description 17
- 230000000241 respiratory effect Effects 0.000 claims description 16
- 230000000747 cardiac effect Effects 0.000 claims description 12
- 230000000638 stimulation Effects 0.000 claims description 9
- 230000000302 ischemic effect Effects 0.000 claims description 8
- 230000029058 respiratory gaseous exchange Effects 0.000 claims description 8
- 230000004044 response Effects 0.000 claims description 6
- 238000012935 Averaging Methods 0.000 claims description 5
- 230000000694 effects Effects 0.000 claims description 4
- 230000003387 muscular Effects 0.000 claims description 3
- 210000001124 body fluid Anatomy 0.000 claims description 2
- 239000010839 body fluid Substances 0.000 claims description 2
- 230000008859 change Effects 0.000 claims description 2
- 210000000038 chest Anatomy 0.000 claims description 2
- 230000037213 diet Effects 0.000 claims description 2
- 235000005911 diet Nutrition 0.000 claims description 2
- 210000004072 lung Anatomy 0.000 claims description 2
- 230000004066 metabolic change Effects 0.000 claims description 2
- 230000036284 oxygen consumption Effects 0.000 claims description 2
- 208000037656 Respiratory Sounds Diseases 0.000 claims 1
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 4
- 238000010586 diagram Methods 0.000 description 4
- 229910052760 oxygen Inorganic materials 0.000 description 4
- 239000001301 oxygen Substances 0.000 description 4
- 238000005086 pumping Methods 0.000 description 4
- 230000009471 action Effects 0.000 description 3
- 230000017531 blood circulation Effects 0.000 description 3
- 230000036772 blood pressure Effects 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 230000036581 peripheral resistance Effects 0.000 description 3
- 210000005241 right ventricle Anatomy 0.000 description 3
- 238000010521 absorption reaction Methods 0.000 description 2
- 210000000709 aorta Anatomy 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 230000001276 controlling effect Effects 0.000 description 2
- 208000031225 myocardial ischemia Diseases 0.000 description 2
- 206010008479 Chest Pain Diseases 0.000 description 1
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 1
- 206010021143 Hypoxia Diseases 0.000 description 1
- 208000002193 Pain Diseases 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- WQZGKKKJIJFFOK-VFUOTHLCSA-N beta-D-glucose Chemical compound OC[C@H]1O[C@@H](O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-VFUOTHLCSA-N 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 208000006218 bradycardia Diseases 0.000 description 1
- 210000003748 coronary sinus Anatomy 0.000 description 1
- 230000001934 delay Effects 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 230000035487 diastolic blood pressure Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 210000003722 extracellular fluid Anatomy 0.000 description 1
- 230000006870 function Effects 0.000 description 1
- 239000008103 glucose Substances 0.000 description 1
- 210000005003 heart tissue Anatomy 0.000 description 1
- 210000003709 heart valve Anatomy 0.000 description 1
- 208000000122 hyperventilation Diseases 0.000 description 1
- 230000000870 hyperventilation Effects 0.000 description 1
- 230000007257 malfunction Effects 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 210000004165 myocardium Anatomy 0.000 description 1
- 210000005036 nerve Anatomy 0.000 description 1
- 230000007383 nerve stimulation Effects 0.000 description 1
- 230000035515 penetration Effects 0.000 description 1
- 230000001105 regulatory effect Effects 0.000 description 1
- 230000036387 respiratory rate Effects 0.000 description 1
- 230000035488 systolic blood pressure Effects 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 230000008719 thickening Effects 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
- A61N1/36521—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure the parameter being derived from measurement of an electrical impedance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/0816—Measuring devices for examining respiratory frequency
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1107—Measuring contraction of parts of the body, e.g. organ, muscle
Landscapes
- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Physiology (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Biophysics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Radiology & Medical Imaging (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Hematology (AREA)
- Pulmonology (AREA)
- Physics & Mathematics (AREA)
- Pathology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Electrotherapy Devices (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
Description
Technisches Gebiettechnical area
Die vorliegende Erfindung bezieht sich auf einen Ischämie-Detektor und auf einen implantierbaren Herzstimulator mit einem solchen Ischämie-Detektor.The The present invention relates to an ischemia detector and to an implantable cardiac stimulator with such an ischemia detector.
Stand der TechnikState of technology
Der Blutfluss und die Durchdringung im Kreislaufsystem eines Lebenswesens ist von der arteriellen muskulären Anspannung, dem sogenannten Tonus, abhängig. So wird der Blutfluss durch den Tonus gesteuert, die Antriebskraft des Flusses ist der Blutdruck in der elastischen Aorta und der Druck in der Aorta wird durch die Pumpaktion des Herzens aufrechterhalten. Für diese Pumpaktion benötigt das Herz Energie in Form von Sauerstoff und Glukose. Etwa 60 % des Sauerstoffs in der interstitiellen Flüssigkeit des Herzens wird innerhalb eines Herzschlages verbraucht. Falls die Energiezufuhr zum Herzen gestört ist, wird die Kontraktionsfähigkeit und die Pumpaktion des Herzens ernsthaft verschlechtert und ein Sauerstoffmangel oder eine Ischämie-Situation entwickeln sich rasch. Ischämie führt zu einem unzureichenden Blutfluss durch den Herzmuskel. Der Grund hierfür ist ein Blockieren oder eine Durchgangskongestion der koronaren Blutgefässe des Herzens. Eine Ischämie wird vom Patienten als ein ernsthafter Brustschmerz empfunden und ist einer der stressigsten Faktoren, die der Organismus kennt. Es sind bereits mehrere Techniken zum Erfassen von Ischämie bekannt. Durch die US-5,156,148 ist ein System zum Behandeln einer Funktionsstörung eines Herzens, beispielsweise einer Ischämie, bekannt geworden, bei der die Variation ausgewählter physiologischer Parameter ausgenutzt wird. In der US-A-4,821,735 sind ein Verfahren und eine Vorrichtung zum Detektieren einer myokardialen Ischämie beschrieben, wobei der systemische vaskuläre Widerstand (SVR) in einem Subjekt überwacht wird und das Vorhandensein einer myokardialen Ischämie erfasst wird, wenn der SVR um wenigstens 60 % über einen Grundlinienwert ansteigt.Of the Blood flow and the penetration in the circulatory system of a life is from the arterial muscular Tension, the so-called Tonus, dependent. This is how the blood flow becomes controlled by the tone, the driving force of the flow is the blood pressure in the elastic aorta and the pressure in the aorta is through the Maintain pumping action of the heart. The heart needs for this pumping action Energy in the form of oxygen and glucose. About 60% of the oxygen in the interstitial fluid of the heart is consumed within a heartbeat. If the energy supply to the heart is disturbed, the contractility becomes and the pumping action of the heart seriously worsened and deteriorated Oxygen deficiency or an ischemic situation develop rapidly. ischemia leads to insufficient blood flow through the heart muscle. The reason for this is a Block or congestive congestion of the coronary blood vessels of the heart. An ischemia is perceived by the patient as a serious chest pain and is one of the most stressful factors that the organism knows. It Several techniques for detecting ischemia are already known. By US-5,156,148 is a system for treating a malfunction of Heart, for example, an ischemia, have become known the variation of selected physiological parameter is utilized. In US-A-4,821,735 are a method and apparatus for detecting a myocardial Ischemia described being the systemic vascular Resistance (SVR) is monitored in a subject and the presence a myocardial ischemia is detected when the SVR increases by at least 60% above a baseline value.
In der US-A-5,497,780 ist eine Vorrichtung zum Erfassen einer Ischämie durch Messen von elektrischen Potentialen zwischen wenigstens drei implantierten Messelektroden beschrieben, wobei zwei der genannten Elektroden mit ihren Polen im Herzen und die dritte Elektrode mit ihrem Pol außerhalb des Herzens liegend implantiert sind.In US-A-5,497,780 is an apparatus for detecting ischemia Measuring electrical potentials between at least three implanted Measuring electrodes, wherein two of said electrodes with her poles in the heart and the third electrode with her pole outside implanted in the heart.
In der US-A-5,199,428 ist eine Technik beschrieben, zum Detektieren einer Ischämie und Bewirken einer Stimulation der, den Blutdruck und die Herzfrequenz regulierenden Nerven, um die Sauerstoffanforderungen des Herzens zu reduzieren, während Stimulationstherapien vorgesehen werden, um die Herzfrequenz des Patienten innerhalb akzeptierbarer Grenzen zu halten, um Bradyarrhythmien und/oder unphysiologische AV-Verzögerungen zu vermeiden, die durch die Nervenstimulation hervorgerufen werden. Die Ischämie-Detektion beruht auf dem Auftreten von Änderungen in der ST-Segment-Variation, verschieden von vorbestimmten oder programmierten Schwellenwerten, oder auf Änderungen im pH und/oder im gelösten Blutsauerstoff im venösen Blutrücklauf im koronaren Sinusbereich des Herzens des Patienten.In US-A-5,199,428 describes a technique for detecting an ischemia and causing a stimulation of, blood pressure and heart rate regulating nerves to the oxygen requirements of the heart while reducing Stimulation therapies are provided to increase the heart rate of the patient Keep patients within acceptable limits to bradyarrhythmias and / or unphysiological AV delays to be caused by the nerve stimulation. The ischemia detection is based on the appearance of changes in the ST segment variation, different from predetermined or programmed Thresholds, or changes in the pH and / or in the dissolved Blood oxygen in the venous Blood return in the coronary sinus area of the patient's heart.
Ein Ischämie-Zustand kann auch durch Analyse aufgezeichneter IECG's oder Oberflächen ECG's detektiert werden, um die Herzfrequenzvariabilität zu bestimmen. Eine Ischämie kann durch einen Leitungsbiegesensor erfasst werden, der am distalen Endabschnitt einer implantierten Herzstimulatorleitung angeordnet ist. Da sich die Herzwand als Ergebnis einer Ischämie verdickt und versteift, kann die damit verbundene Änderung im Bewegungsmuster der Herzwand auf diese Weise erfasst werden. Auch eine Schallabsorption wird durch Änderungen in der Steifigkeit des Herzgewebes beeinflusst und durch Messen der Absorption von Schallwellen, die beispielsweise beim Herzklappenschließen auf ihrem Weg vom oberen Abschnitt des Ventrikels zum Apex-Bereich erzeugt werden, kann eine Ischämie-Situation erfasst werden. Eine Ischämie verschlechtert die Effizienz des Pumpens des Herzens und eine Ischämiesituation kann deshalb auch erfasst werden durch Studieren der Blutdrücke und der Herzzeitvolumina. Somit kann durch Messen der Differenz zwischen dem systolischen und dem diastolischen Druck und durch Vergleichen dieser Differenz, die aus einem Herzschlag erhalten worden ist, mit der Differenz, die aus dem nächsten Herzschlag erhalten worden ist, eine Ischämie erfasst werden. Mit Hilfe eines Flusssensors zum Messen des Herzzeitvolumens kann auch ein Ischämie-Zustand erfasst werden.One Ischemic state can also be detected by analyzing recorded IECG's or surface ECG's to determine heart rate variability. An ischemia can be detected by a conduction bending sensor located at the distal end portion an implanted cardiac stimulator line is arranged. That I thickening and stiffening the heart wall as a result of ischemia, can change that be detected in the motion pattern of the heart wall in this way. Also, sound absorption is due to changes in stiffness of the heart tissue and by measuring the absorption of Sound waves, for example, the heart valve closing on their path from the upper portion of the ventricle to the apex area an ischemic situation can be detected become. An ischemia worsens the efficiency of pumping the heart and an ischemic situation can therefore also be detected by studying the blood pressure and the cardiac output. Thus, by measuring the difference between the systolic and diastolic pressures and by comparing these Difference that has been obtained from a heartbeat, with the Difference coming from the next Heart beat has been obtained, an ischemia can be detected. With help a flow sensor for measuring the cardiac output can also be Ischemic state be recorded.
Wie oben erwähnt, ist ein Ischämie-Zustand normalerweise mit ernsthaften Schmerzen verbunden, die den Patienten zwingen sich hinzusetzen oder hinzulegen, mit reduzierter Herzfrequenz als Folge hiervon. Gleichzeitig fühlt der Körper die Notwendigkeit für ein verstärktes Atmen, sogenannte Hyperventilation.As mentioned above, is an ischemic condition usually associated with serious pain that force the patient out sit down or lie down, with reduced heart rate as a result hereof. Simultaneously feels the body the need for a reinforced one Breathing, so-called hyperventilation.
Offenbarung der Erfindungepiphany the invention
Das Ziel der Erfindung ist es, einen neuen Typ eines Ischämiedetektors verfügbar zu machen, dessen Funktion auf den oben erwähnten Bedürfnissen eines Patienten beruht, der von einer Ischämie befallen ist.The The aim of the invention is a new type of ischemia detector available whose function is based on the above-mentioned needs of a patient, which is affected by ischaemia is.
Dieses Ziel wird durch einen Detektor gemäß Anspruch 1 erreicht.This Target is achieved by a detector according to claim 1.
Für eine gesunde Person resultiert die Notwendigkeit einer vergrößerten Atmungsfrequenz aus einer vergrößerten Leistung oder Arbeitsbelastung der Person. Der Ischämie-Detektor gemäß dieser Erfindung beruht auf dem Auftreten der abnormalen Kombination einer niedrigen Arbeitsbelastung und einer hohen Atmungsaktivität, die typisch für Ischämie-Patienten ist.For a healthy Person results in the need for an increased respiratory rate out of one increased performance or workload of the person. The ischemia detector according to this The invention is based on the occurrence of the abnormal combination of a low workload and high breathability typical for ischemic patients is.
Gemäß einer vorteilhaften Ausführungsform des erfindungsgemäßen Ischämie-Detektors ist eine Mittelwertbildungsvorrichtung mit der genannten Arbeitsbelastungs- und Atmungsabfühlvorrichtung verbunden, um während Zeitperioden vorbestimmter Längen der Arbeitsbelastung bzw. Atmungsaktivität Mittelwerte zu bilden und entsprechende Mittelwertsignale zu der genannten Detektionsvorrichtung zu liefern. Auf diese Weise werden fehlerhafte Erfassungen in Folge zufälliger Veränderungen zeitlich vorübergehender Natur in der Arbeitsbelastung und in der Atmungsaktivität vermieden.According to one advantageous embodiment of the ischemia detector according to the invention is an averaging device with said workload and respiratory sensing device connected to during Time periods of predetermined lengths the workload or respiratory activity to form averages and corresponding average signals to said detection device to deliver. In this way, erroneous acquisitions in sequence random changes temporally temporary Avoiding nature in workload and breathability.
Gemäß einer weiteren vorteilhaften Ausführungsform des erfindungsgemäßen Detektors ist eine Warnvorrichtung ausgebildet, in Reaktion auf eine erfasste Ischämie aktiviert zu werden.According to one further advantageous embodiment of the detector according to the invention a warning device is configured in response to a detected ischemia to be activated.
Gemäß einem weiteren Aspekt der Erfindung wird ein implantierbarer Herzstimulator vorgesehen, mit Mitteln zum Verändern der Stimulationsfrequenz und einem Ischämie-Detektor, wie oben beschrieben.According to one Another aspect of the invention is an implantable cardiac stimulator provided with means for changing the pacing rate and an ischemia detector as described above.
Gemäß einer vorteilhaften Ausführungsform der Erfindung enthält für diesen Aspekt der Herzstimulator eine mit dem Ischämie-Detektor verbundene Steuervorrichtung zum Steuern der Stimulationsfrequenzveränderungsvorrichtung, um die Stimulationsfrequenz in Reaktion auf die Erfassung einer Ischämie zu erniedrigen.According to one advantageous embodiment of the Invention contains For this Aspect of the heart stimulator connected to the ischemia detector control device for controlling the pacing rate varying device to the Reduce pacing rate in response to the detection of ischemia.
Kurze Beschreibung der ZeichnungenShort description the drawings
Um die Erfindung näher im Einzelnen zu erläutern, werden als Beispiele ausgewählte Ausführungsformen der Erfindung nachfolgend anhand der Zeichnungen beschrieben, in denenAround the invention closer to explain in detail are selected as examples embodiments the invention described below with reference to the drawings, in to those
Beschreibung bevorzugter Ausführungsformendescription preferred embodiments
Die
Detektionsvorrichtung
Wenn
eine vorbestimmte Beziehung zwischen den Signalen aus der Mittelwertbildungsvorrichtung
Ein
Beispiel der vorbestimmten Beziehung zwischen Arbeitsbelastung x
und Atmungsaktivität
y, die im Speicher
Eine
alternative Ausführungsform
der Detektionsvorrichtung ist in
Der
Komparator
Eine
Arbeitsbelastungsabfühlvorrichtung
Die
Abfühlvorrichtung
Die Gleichstrom-Vorspannung wird während eines Teils des Atemzyklus und an bestimmten definierten Positionen des Herzzyklus zugeführt.The DC bias is during a Part of the respiratory cycle and at certain defined positions of the Heart cycle supplied.
Der
Herzstimulator
Diese
Warnvorrichtung
Bei
dem erfindungsgemäßen Herzstimulator wird
die Stimulationsfrequenz in Reaktion auf die Erfassung einer Ischämie herabgesetzt.
Es gibt verschiedene Möglichkeiten
der Herabsetzung der Stimulationsfrequenz. Die Steuervorrichtung
Die
Atmungsaktivität
kann durch Messen des Wechselstromwiderstandes zwischen den zwei Elektroden
Die
Elektroden
Andere Möglichkeiten der Bestimmung der Atmungsaktivität des Patienten bestehen in der Benutzung eines Sensors zum Abfühlen von Atemtönen im Thorax des Patienten oder einem Sensor zum Abfühlen von Lungenvolumenänderungen.Other options The determination of the respiratory activity of the patient consist in using a sensor to sense breaths in the thorax the patient or a sensor for sensing lung volume changes.
Es können auch andere Arten einer Arbeitsbelastungsabfühlvorrichtung bei der vorliegenden Erfindung benutzt werden. So kann die Arbeitsbelastungsabfühlvorrichtung einen Sensor zum Abfühlen von Druckwellen in Körperflüssigkeiten enthalten, die durch die Arbeitsbelastung oder Aktivität des Patienten erzeugt werden. Die Arbeitsbelastungsabfühlvorrichtung kann einen Sensor zum Abfühlen metabolischer Änderungen, wie Änderungen in der Ernährung und im Sauerstoffverbrauch des Patienten umfassen.It can also other types of workload sensing device in the present invention Invention be used. Thus, the workload sensing device a sensor for sensing Pressure waves in body fluids included by the workload or activity of the patient be generated. The workload sensing device may be a sensor to feel metabolic changes, like changes in the diet and in the oxygen consumption of the patient.
Claims (17)
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
SE9700427A SE9700427D0 (en) | 1997-02-07 | 1997-02-07 | Ischemia detector |
SE9700427 | 1997-02-07 | ||
PCT/SE1998/000203 WO1998034537A1 (en) | 1997-02-07 | 1998-02-05 | Ischemia detector |
Publications (2)
Publication Number | Publication Date |
---|---|
DE69828176D1 DE69828176D1 (en) | 2005-01-20 |
DE69828176T2 true DE69828176T2 (en) | 2005-12-22 |
Family
ID=20405708
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE69828176T Expired - Lifetime DE69828176T2 (en) | 1997-02-07 | 1998-02-05 | ISCHEMIA DETECTOR |
Country Status (5)
Country | Link |
---|---|
US (1) | US6264606B1 (en) |
EP (1) | EP1011432B1 (en) |
DE (1) | DE69828176T2 (en) |
SE (1) | SE9700427D0 (en) |
WO (1) | WO1998034537A1 (en) |
Families Citing this family (105)
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- 1998-02-05 DE DE69828176T patent/DE69828176T2/en not_active Expired - Lifetime
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US6264606B1 (en) | 2001-07-24 |
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